Drs. Barbaccia (physician) and Lurie (sociologist) propose to study how professional staffs of acute hospitals assist elderly patients, their spouses, families and significant others to prepare for convalescence, readaptation at home after an episode of acute hospitalization. As lengths of hospital stay of Medicare beneficiaries decrease through utilization control mechanisms, the need for careful planning for the social, psychological, medical and nursing needs of the patient become crucial. We suppose that successful discharge planning is based on assessment of the elderly patient's needs for post-hospital services by the in-hospital health care professionals; on information about the home setting into which the patient is to return; and on the availability of assistance from natural support systems. The study proposes to define how post-hospital services are actually secured for/by elderly patients; how the assessment of need is transformed into a service plan; and the outcome of services received on health and functional status of the patient post-hospital. Since most convalescent care is provided by families and significant others, we propose to study how they are prepared and formally assisted in managing and coping with attitudes, feelings and concerns, needs and events resulting from the patient's compromised mental and physical health status and functional status. Study methodology involves observing the discharge planning process in three hospital settings, comprehensively assessing 200 consecutively discharged elderly patients; and assessing the outcome of services actually received on the health and functional status of the patient two months after discharge. The significance of the proposed study is based on the fact that no information is available on the actual process and impact of linking acute hospital elderly patients to health care and supportive services in the community (often avoiding unnecessary institutionalization and repeat hospitalization). The study will provide information and methods for improving quality of care for the elderly; a conceptual framework of discharge planning, a minimum data base for planning and management of posthospital care; and a training manual for health professionals.